8th Annual Acadia Eye Conference
Registration Form
Attendees Name
*
First Name
Last Name
Email
*
example@example.com
Add Cell Phone
*
-
Area Code
Phone Number
SUBTOTAL: Add $325 per attendee
*
CREDITS
If sending a check, minus out your fee total from the Subtotal. Otherwise it will take you to PayPal to pay the fees.
Paypal Processing Fee
TOTAL PAYMENT
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USD
Total Payment as noted above
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